Form S1 "Certified Rehabilitation Application - Evaluation of Significance" - South Carolina

What Is Form S1?

This is a legal form that was released by the South Carolina Department of Archives & History - a government authority operating within South Carolina. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on May 1, 2019;
  • The latest edition provided by the South Carolina Department of Archives & History;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form S1 by clicking the link below or browse more documents and templates provided by the South Carolina Department of Archives & History.

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Download Form S1 "Certified Rehabilitation Application - Evaluation of Significance" - South Carolina

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S1 - Evaluation of Significance
South Carolina Historic Rehabilitation Incentives - Certified Rehabilitation Application
Certified Historic Residential Structure - SC Code of Laws Section 12-6-3535(B)
PLEASE NOTE:
Signed and completed forms must be mailed to State Tax Credit Review, State Historic Preservation Office, SC Department
of Archives and History, 8301 Parklane Road, Columbia, SC 29223. Digital submissions are not accepted.
1. P
I
roPerty
nformatIon
Historic Property Name:
County:
Address:
City:
State: SC Zip:
Has the street address changed?
Yes
No
Don’t Know
If yes, what was the previous address?
Name of National Register Historic District (if applicable
):
2. t
s
axPayer
s
tatement
Name:
Phone:
E-mail:
Address:
City:
State:
Zip:
By signing this form, I attest that the information provided herein is true and complete to the best of my knowledge. Further, I understand
that falsification of factual representations in this application is subject to civil and criminal penalties as provided in 12-54-43 and 12-54-
44 of the SC Code of Laws, 1976. An original signature is required.
Signature
Date
3. P
c
(If Different From Taxpayer)
roject
ontact
Name:
Phone:
E-mail
Address:
City:
State:
Zip:
4. A
ttachments
You must include the following information with your signed and completed application. Incomplete applications will be placed on hold until
you provide the requested information. Please send complete information with the initial submission.
MAPS showing streets, cross streets, and adjacent property parcels (see Instructions)
PHOTOGRAPHS in color, printed no more than 2 to a page, of the interior, exterior and any outbuildings (see Instructions)
STATE HISTORIC PRESERVATION OFFICE USE ONLY
As documented on this form and accompanying attachments,
The residence is a ‘certified historic residential structure’ and eligible to pursue the state income tax credit created by SC Code of Laws
12-6-3535 (B), because it:
Contributes to the significance of the above-referenced National Register historic district.
Listed individudally or meets the criteria for individual listing in the National Register of Historic Places.
Contributing outbuilding(s) are:
Non-contributing outbuilding(s) are:
The residence IS NOT a ‘certified historic residential structure’ according to SC Code of Laws 12-6-3535(B) and therefore ineligible to
pursue the tax credit, because it:
DOES NOT contribute to the significance of the above-referenced National Register historic district.
DOES NOT meet the criteria for individual listing in the National Register of Historic Places.
See attached sheets
S -
-
State Historic Preservation Officer - Authorized Signature
Date
Project Number
May 2019
Page 1 of 2 or 4
S1 - Evaluation of Significance
South Carolina Historic Rehabilitation Incentives - Certified Rehabilitation Application
Certified Historic Residential Structure - SC Code of Laws Section 12-6-3535(B)
PLEASE NOTE:
Signed and completed forms must be mailed to State Tax Credit Review, State Historic Preservation Office, SC Department
of Archives and History, 8301 Parklane Road, Columbia, SC 29223. Digital submissions are not accepted.
1. P
I
roPerty
nformatIon
Historic Property Name:
County:
Address:
City:
State: SC Zip:
Has the street address changed?
Yes
No
Don’t Know
If yes, what was the previous address?
Name of National Register Historic District (if applicable
):
2. t
s
axPayer
s
tatement
Name:
Phone:
E-mail:
Address:
City:
State:
Zip:
By signing this form, I attest that the information provided herein is true and complete to the best of my knowledge. Further, I understand
that falsification of factual representations in this application is subject to civil and criminal penalties as provided in 12-54-43 and 12-54-
44 of the SC Code of Laws, 1976. An original signature is required.
Signature
Date
3. P
c
(If Different From Taxpayer)
roject
ontact
Name:
Phone:
E-mail
Address:
City:
State:
Zip:
4. A
ttachments
You must include the following information with your signed and completed application. Incomplete applications will be placed on hold until
you provide the requested information. Please send complete information with the initial submission.
MAPS showing streets, cross streets, and adjacent property parcels (see Instructions)
PHOTOGRAPHS in color, printed no more than 2 to a page, of the interior, exterior and any outbuildings (see Instructions)
STATE HISTORIC PRESERVATION OFFICE USE ONLY
As documented on this form and accompanying attachments,
The residence is a ‘certified historic residential structure’ and eligible to pursue the state income tax credit created by SC Code of Laws
12-6-3535 (B), because it:
Contributes to the significance of the above-referenced National Register historic district.
Listed individudally or meets the criteria for individual listing in the National Register of Historic Places.
Contributing outbuilding(s) are:
Non-contributing outbuilding(s) are:
The residence IS NOT a ‘certified historic residential structure’ according to SC Code of Laws 12-6-3535(B) and therefore ineligible to
pursue the tax credit, because it:
DOES NOT contribute to the significance of the above-referenced National Register historic district.
DOES NOT meet the criteria for individual listing in the National Register of Historic Places.
See attached sheets
S -
-
State Historic Preservation Officer - Authorized Signature
Date
Project Number
May 2019
Page 1 of 2 or 4
S1 - Evaluation of Significance
South Carolina Historic Rehabilitation Incentives - Certified Rehabilitation Application
Certified Historic Residential Structure - SC Code of Laws Section 12-6-3535(B)
5. P
D
roPerty
escrIPtIon
Date(s) of Construction:
Source :
Describe Previous Alterations/Changes or Additions to exterior/interior if known (include dates):
Has the building been moved?
Yes
No
If Yes, date(s) of move(s)?
If Yes, where was the original location?
Are outbuildings on the property?
Yes
No
If Yes, please list each building on the property, regardless of age or integrity. Provide the approximate date of construction and describe
any alterations or additions. Please include photographs of each outbuilding (see
Tips for Taking Photographs
in Instructions).
t
c
s1 a
:
hIs
omPletes the
PPlIcatIon for the followIng
Any property listed in the National Register of Historic Places (District or Individually);
t
r
P
m
B
c
f
f
:
he
emaInIng
ages
ust
e
omPleteD
or the
ollowIng
Any property that is NOT listed in the National Register (District or Individually)
May 2019
Page 2 of 2 or 4
S1 - Evaluation of Significance
South Carolina Historic Rehabilitation Incentives - Certified Rehabilitation Application
Certified Historic Residential Structure - SC Code of Laws Section 12-6-3535(B)
Include this page ONLY if the property is NOT LISTED INDIVIDUALLY IN THE NATIONAL REGISTER or LOCATED IN A NATIONAL REGISTER-LISTED
HISTORIC DISTRICT.
5. P
D
(
)
roPerty
escrIPtIon
contInueD
r
m
f
E
W
r
f
N
s
oof
atErIal
ouNdatIoNs
xtErIor
alls
oof
orm
umbEr of
torIEs
Gable
Brick pier
Brick
Wood shingle
Brick pier- infilled
Stone
Hip
Slate
Mixed
Brick wall
Stucco
Clay tile
Other:
Stone
Wood siding
Standing seam metal
Concrete block
Wood shingle
Asphalt shingle
Synthetic Siding
Stucco
Other:
Type:
Other:
Other:
C
W
I
C
I
W
INdoWs
NtErIor
EIlINgs
hImNEys
NtErIor
alls
Plaster
Brick
Wood
Plaster
Drywall
Stuccoed brick
Metal
Drywall
Wood
Stone
Aluminum
Beaded board
Wainscotting
Brick and stone
Vinyl
Wood
Other:
Other:
Other:
Type:
Other:
Desribe any other significant architectural or structural features:
May 2019
Page 3 of 4
S1 - Evaluation of Significance
South Carolina Historic Rehabilitation Incentives Certified Rehabilitation Application
Certified Historic Residential Structure - SC Code of Laws Section 12-6-3535(B)
6. P
s
:
roPerty
IgnIfIcance
Architect/Contractor (if known):
Source:
Who built the building? Who has lived in the building and when?
May 2019
Page 4 of 4
Page of 4